PREMIERE PERINATAL ASSOCIATES (NPI# 1417906561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417906561 |
| Entity Type | Organization |
| Organization Name | PREMIERE PERINATAL ASSOCIATES |
| Practice Address |
200 Nw 7th Ave Premiere Perinatal Associates Ft Lauderdale FL 33311-9026 |
| Mailing Address |
500 Se 17th St Suite 100 Ft Lauderdale FL 33316-2547 |
| Practice Telephone | 9547596789 |
| Practice Fax Number | 9194250478 |
| Mailing Telephone | 9194251565 |
| Mailing Fax Number | 9194250478 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2019-09-17 |
| Authorized Official Name | DR. BERTRAM WALLS (OWNER/PRESIDENT) |
| Authorized Official Telephone | 9548382371 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
ME43546 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 273189401 | 05 |
| Street Address |
200 NW 7TH AVE PREMIERE PERINATAL ASSOCIATES |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33311-9026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383352 | Sheila Gibson | Advanced Practice Midwife | 200 Nw 7th Ave, Ft Lauderdale, FL 33311-9026 | 2005-08-12 |
| 1720431133 | Christopher Pham | Dentist | 200 Nw 7th Ave, Ft Lauderdale, FL 33311-9026 | 2016-07-20 |
| 1437451465 | Janet H. Gerner | Social Worker | 200 Nw 7th Ave, Social Services, Ft Lauderdale, FL 33311-9026 | 2010-11-24 |
| 1750324034 | Alix Andre Cange | Physician Assistant | 200 Nw 7th Ave, Ft Lauderdale, FL 33311-9026 | 2006-06-14 |
| 1144279233 | Phoenix Emergency Medicine of Broward LLC | Emergency Medicine | 200 Nw 7th Ave, Phoenix Physicians, Ft Lauderdale, FL 33311-9026 | 2006-05-08 |
| 1225087315 | Phoenix Obstetrics/gynecology, LLC | Obstetrics & Gynecology | 200 Nw 7th Ave, Ft Lauderdale, FL 33311-9026 | 2006-05-08 |
| 1205890118 | Sudha Gupta | Pediatrics | 200 Nw 7th Ave, Ft Lauderdale, FL 33311 | 2006-04-17 |
| 1588653760 | Mark Walker | Family Medicine | 200 Nw 7th Ave, Phoenix Emergency Medicine of Broward, LLC, Ft Lauderdale, FL 33311-9026 | 2005-10-19 |
| 1215926670 | Maria Fedor | Family Medicine | 200 Nw 7th Ave, Phoenix Emergency Medicine of Broward, Ft Lauderdale, FL 33311-9026 | 2005-10-18 |
| 1982693610 | Gessy Targete-johnson | Nurse Practitioner | 200 Nw 7th Ave, Phoenix Obstetrics/gynecology, LLC, Ft Lauderdale, FL 33311-9026 | 2005-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
| 1942769534 | Cbd Skeletal Solutions, LLC | Durable Medical Equipment & Medical Supplies | 630 Tennis Club Drive, Outerbridge - 407, Ft. Lauderdale, FL 33311 | 2019-03-14 |
| 1770049116 | Jordan Matthew Nodelman | Social Worker | 871 W Oakland Park Boulevard, Oakland Park, FL 33311 | 2019-02-11 |
| 1417422304 | Carebridge Home Health of Flrorida | Home Health | 1871 West Oakland Park Blvd, Suite E, Oakland Park, FL 33311 | 2018-10-08 |
| 1992287130 | Michael Ray Johnson | Counselor | 900 Nw 31 Ave, Suite #2000, Ft Laud, FL 33311 | 2018-09-04 |
| 1477047058 | Latino Medical Center IIi | General Practice | 3670 W Oakland Blvd, Lauderdale Lakes, FL 33311 | 2018-06-18 |
| 1316442049 | Anita Fox | Non-emergency Medical Transport (VAN) | 2880 West Oakland Park Blvd, 234, Oakland Park, FL 33311 | 2018-03-26 |
| 1669995957 | Lola J Lewis-walker | Nurse Practitioner | 925 Nw 14th St, Fort Lauderdale, FL 33311 | 2017-07-19 |
| 1598294936 | Abigail D Garcia | Counselor | 713 Nw 1st Ave, Fort Lauderdale, FL 33311 | 2017-06-08 |
| 1548712524 | Hubert Faustin | Counselor | 1409 Nw 1st Avenue, Fort Lauderdale, FL 33311 | 2016-10-26 |
| Find all providers in zip 33311 | ||||
| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386643187 | Premiere Perinatal Associates, Pa | Obstetrics & Gynecology | 500 Se 17th St, Suite 100, Ft Lauderdale, FL 33316-2547 | 2005-07-14 |
| 1477502540 | Premiere Perinatal Associates Pa | Obstetrics & Gynecology | 1600 S Andrews Ave, Premiere Perinatal Associates, Ft Lauderdale, FL 33316-2510 | 2006-05-08 |
| 1548259278 | Adolfo Gonzalez-garcia | Obstetrics & Gynecology | 500 Se 17th St, Premiere Perinatal Associates, Ft Lauderdale, FL 33316-2547 | 2005-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568877538 | Sunshine Perinatology Specialists, M.d., P.a. | Obstetrics & Gynecology | 2310 North Blvd W, Davenport, FL 33837 | 2014-06-27 |
| 1780983114 | Maternal Fetal Medicine of Southwest Florida | Obstetrics & Gynecology | 210 Del Prado Blvd, Suite 1, Cape Coral, FL 33990-1763 | 2011-03-24 |
| 1427357854 | Maternal Fetal Medine of Sw Flordia | Obstetrics & Gynecology | 26800 S. Tamiami Tr, Suite 230, Bonita Springs, FL 34134-4390 | 2011-03-24 |
| 1336305614 | Christensen Maternal & Fetal Medicine | Obstetrics & Gynecology | 2100 Aloma Ave, Suite 100, Winter Park, FL 32792-3301 | 2008-08-06 |
| 1871782748 | Jose R Duncan Arosemena | Obstetrics & Gynecology | 2 Tampa General Cir Fl Circle6, Tampa, FL 33606-3603 | 2007-10-17 |
| 1336350446 | Amy Alicia Flick | Obstetrics & Gynecology | 15735 Pines Blvd, Pembroke Pines, FL 33027-1207 | 2007-05-24 |
| 1639214190 | Fausto Innamorati | Obstetrics & Gynecology | 780 Sw 28th Street, Fort Lauderdale, FL 33315-2643 | 2007-02-21 |
| 1831299767 | Ruel Tyrone Stoessel | Obstetrics & Gynecology | 8645 N Military Trail, Suite 508, Palm Beach Gardens, FL 33410-6296 | 2006-09-22 |
| 1891709630 | Jerry N Gilles | Obstetrics & Gynecology | 300 Se 17th Street, Suite 300, Fort Lauderdale, FL 33316 | 2006-07-28 |
| 1003837527 | Daniel George Kiefer | Obstetrics & Gynecology | 3438 Lawton Rd Ste 2a, Orlando, FL 32803 | 2006-07-21 |
| Find all providers with the same taxonomy | ||||
| City | FT LAUDERDALE |
| Zip Code | 33311 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.